Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
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J Pediatr Health Care · Jan 2019
The Use of Codeine and Tramadol in the Pediatric Population-What is the Verdict Now?
Codeine and tramadol are opioid analgesics approved for the management of pain in the United States. Both agents are metabolized in the liver to active compounds via the cytochrome P450 2D6 enzyme. Case reports of pediatric patients with overactive CYP2D6 enzymes have been reported. ⋯ In 2017, the U. S. Food and Drug Administration updated their warnings regarding codeine and tramadol use in the pediatric population, making their use contraindicated in patients under the age of 12 years.
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J Pediatr Health Care · Jan 2019
Case ReportsChild Maltreatment Red Flags: Two Cases of Bruising in Premobile Infants.
Child maltreatment is a serious public health concern in the United States. Young infants and children younger than 3 years are at the highest risk of being abused and can experience both acute injuries and long-term developmental, behavioral, and mental health problems. ⋯ It is not uncommon for an abused child to present with an injury that at first glance may seem trivial but is actually suspicious for physical abuse and later be found to have abusive fractures or head trauma. The following case presentations show the importance of recognizing sentinel injuries and red flags for maltreatment in young, premobile infants with unexplained bruises.